Provider Demographics
NPI:1891242731
Name:BART F. ROBISON DDS
Entity type:Organization
Organization Name:BART F. ROBISON DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-651-9394
Mailing Address - Street 1:16521 13TH AVE W
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-8528
Mailing Address - Country:US
Mailing Address - Phone:360-651-9394
Mailing Address - Fax:360-651-9262
Practice Address - Street 1:16521 13TH AVE W
Practice Address - Street 2:SUITE 101
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-8528
Practice Address - Country:US
Practice Address - Phone:360-651-9394
Practice Address - Fax:360-651-9262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
600288OtherUNITED CONCORDIA
WADE00008488OtherDELTA DENTAL